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Biomedical subjects

I Bone

Publications and source records attributed to I Bone.

At least 55 records · Page 3Linked to original sources
PubMed1992

Neurotoxic treatment in a patient with brachial neuritis associated with Hodgkin's disease.

Brachial neuritis is a rare form of neuropathy associated with Hodgkin's disease. In the patient we describe, a brachial neuritis occurred during chemotherapy for Hodgkin's disease. He later developed a marked sensory peripheral neuropathy with vincristine. Lhermitte's sign also developed following modest doses of radiotherapy (35 Gy in 20 fractions to the whole cervical cord). We suggest that neurotoxic treatment must be given with extra care to patients with non-metastatic tumour induced neuropathies.

Adult↗
PubMed1991

MRI in the management of suspected cervical spondylotic myelopathy.

One hundred and two patients with suspected cervical spondylotic myelopathy were prospectively investigated using MRI as the initial imaging technique. The aim was to discover if clinicians could manage patients with MRI alone, or if they would find a second investigation necessary. Eighty two patients were managed using MRI alone, 34 of whom were treated surgically. Twenty patients had a second investigation: a myelogram in 18 and a CT myelogram in two. This was performed in nine patients to exclude structural pathology in the thoracic or lumbar region (which was not examined with MRI), and in 11 to obtain more specific information about the cervical region. Only five of these 20 patients had surgical treatment. The diagnosis changed after the second investigation in four patients, but management was not influenced in any of these. MRI is a satisfactory alternative to myelography for most patients with suspected cervical spondylotic myelopathy.

Adult↗
PubMed1990

Tc99m HM-PAO single photon emission computed tomography in temporal lobe epilepsy.

We present the results of single photon emission computed tomography (SPECT) in 40 patients with temporal lobe epilepsy and normal computed transmission tomography (CT). Abnormalities of regional cerebral blood flow were found in 26 patients. There was focal hypoperfusion alone in 14, focal hyperperfusion alone in 6, and both types of abnormality in 6. In 4 patients there were bilateral abnormalities. Repeat SPECT showed persistence of interictal hyperperfusion in 5/12 patients. There were no significant correlations between SPECT findings and clinical parameters, and no relation between the persistence of interictal hyperperfusion and time since last seizure or seizure frequency. Where SPECT and multiple surface EEG recordings were both lateralising, agreement between them was good. The results of this study support the usefulness of HMPAO SPECT in detecting lateralising abnormalities in temporal lobe epilepsy. Interictal hyperperfusion may be commoner than previous publications suggest, and may be persistent in some cases.

Adolescent↗
PubMed1990

CT, MR and SPECT imaging in temporal lobe epilepsy.

Cranial computed tomography (CT) with modified temporal lobe technique, 0.15T magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT) were carried out on 30 patients with intractable temporal lobe epilepsy. Lateralising abnormalities were detected in 21/30 patients overall. Specific lesions were detected by CT in one patient and by MRI in seven patients (in one case bilateral). In addition CT detected asymmetry of the sylvian fissures or temporal horns in 10 patients, and MRI in eight patients. SPECT detected lateralising abnormalities in 19 patients (in five cases bilateral). It is concluded that low field MRI is superior to modified CT in demonstrating subtle structural lesions of the temporal lobe. Functional scanning with SPECT supports the evidence of origin of an epileptic focus in a substantial proportion of cases and may improve the selection of patients for surgery.

Adolescent↗
PubMed1989

Comparison of magnetic resonance imaging and computed tomography in suspected lesions in the posterior cranial fossa.

OBJECTIVE: To compare computed tomography and magnetic resonance imaging in investigating patients suspected of having a lesion in the posterior cranial fossa. DESIGN: Randomised allocation of newly referred patients to undergo either computed tomography or magnetic resonance imaging; the alternative investigation was performed subsequently only in response to a request from the referring doctor. SETTING: A regional neuroscience centre serving 2.7 million. PATIENTS: 1020 Patients recruited between April 1986 and December 1987, all suspected by neurologists, neurosurgeons, or other specialists of having a lesion in the posterior fossa and referred for neuroradiology. The groups allocated to undergo computed tomography or magnetic resonance imaging were well matched in distributions of age, sex, specialty of referring doctor, investigation as an inpatient or an outpatient, suspected site of lesion, and presumed disease process; the referring doctor's confidence in the initial clinical diagnosis was also similar. INTERVENTIONS: After the patients had been imaged by either computed tomography or magnetic resonance (using a resistive magnet of 0.15 T) doctors were given the radiologist's report and a form asking if they considered that imaging with the alternative technique was necessary and, if so, why; it also asked for their current diagnoses and their confidence in them. MAIN OUTCOME MEASURES: Number of requests for the alternative method of investigation. Assessment of characteristics of patients for whom further imaging was requested and lesions that were suspected initially and how the results of the second imaging affected clinicians' and radiologists' opinions. RESULTS: Ninety three of the 501 patients who initially underwent computed tomography were referred subsequently for magnetic resonance imaging whereas only 28 of the 493 patients who initially underwent magnetic resonance imaging were referred subsequently for computed tomography. Over the study the number of patients referred for magnetic resonance imaging after computed tomography increased but requests for computed tomography after magnetic resonance imaging decreased. The reason that clinicians gave most commonly for requesting further imaging by magnetic resonance was that the results of the initial computed tomography failed to exclude their suspected diagnosis (64 patients). This was less common in patients investigated initially by magnetic resonance imaging (eight patients). Management of 28 patients (6%) imaged initially with computed tomography and 12 patients (2%) imaged initially with magnetic resonance was changed on the basis of the results of the alternative imaging. CONCLUSIONS: Magnetic resonance imaging provided doctors with the information required to manage patients suspected of having a lesion in the posterior fossa more commonly than computed tomography, but computed tomography alone was satisfactory in 80% of cases...

Brain Diseases↗
PubMed1989

Blindness in eclampsia: CT and MR imaging.

Three cases of cortical blindness complicating eclampsia are described, with magnetic resonance imaging (MRI) and X-ray computed tomography (CT). The correspondence of MRI lesions (hyperintense on T2 weighted, and hypointense on T1 weighted sections) and low attenuation lesions on CT scan indicated ischaemia rather than haemorrhage as the pathological mechanism.

Adult↗
PubMed1989

The effect of chorda tympani section on ipsilateral and contralateral salivary secretion and taste in man.

Bilateral chorda tympani section is an accepted treatment for troublesome sialorrhoea. Nevertheless the effects of this operation have been poorly studied. Twenty patients were studied with unilateral chorda tympani section and a healthy contralateral ear. The effects on ipsilateral and contralateral stimulated submandibular and parotid flow and taste recognition and detection thresholds were measured. Stimulated submandibular flow accounted for only 27% of the total salivary flow. Chorda tympani section had no effect on submandibular flow in seven patients and only reduced submandibular flow by approximately 54% in the remaining 13 patients. No significant effect was observed on ipsilateral parotid flow rate. Electrogustometric taste detection thresholds were more than twice the accepted upper limit of normal on the lesioned side and taste recognition thresholds were also markedly abnormal. Chorda tympani section alone is a poor method of reducing stimulated salivary flow.

Adolescent↗
PubMed1989

Single central nervous system lesions can simulate multiple sclerosis.

Three cases are reported in which an initial misdiagnosis of multiple sclerosis was made. In each of these a single central nervous system lesion with space occupying effect was present. These lesions caused confusion because multiple closely running neurological tracts were affected, and there was relapse and remission in the neurological signs and symptoms produced. We conclude that such cases need careful assessment to determine whether a single structural lesion could explain the presentation. Early imaging may show remediable lesions or prevent unnecessary steroid therapy.

Adolescent↗
PubMed1989

Neurological features of HIV-related disease in Glasgow.

The neurological features of 10 patients with HIV-related disease seen in Glasgow between July 1984 and May 1988 are described. Two of these patients presented with ARC and eight with AIDS. Six patients showed features consistent with a diagnosis of AIDS-dementia complex, one had cerebral toxoplasmosis, one had CNS lymphoma, one had a probable drug-induced encephalopathy and one patient had a meningoencephalitis of undetermined cause. Seven of these patients have now died. The implications of these findings are discussed.

AIDS-Related Complex↗
PubMed1987

Human cranial CSF volumes measured by MRI: sex and age influences.

Accurate measurements of CSF volumes would assist in the diagnosis of several important neurological conditions. Using Magnetic Resonance Imaging (MRI) we have devised a method to measure both total intracranial CSF volume and ventricular volume. This initial study, in normal humans, provides an answer to two longstanding questions: first, do these volumes differ between the sexes; second, do both total and ventricular CSF volumes increase with normal aging? We found that the total cranial CSF volume and skull size of males were significantly greater than those of females, but that there was not a statistically significant difference between the ventricular volumes of the sexes. Total cranial CSF volume increased steeply with age in both sexes but although there was an increase in ventricular volume with age in males, no significant increase with age could be demonstrated in females.

Adult↗
PubMed1987

Evoked taste thresholds in a normal population and the application of electrogustometry to trigeminal nerve disease.

No standardised method for taste threshold measurement is available and therefore comparison between clinical studies is difficult. An electrogustometer was evaluated in normal subjects. No sex difference in taste threshold was noted; however, there was a significant elevation in detection threshold with age and smoking. Electrogustometric values both in patients before and after surgery for trigeminal neuralgia and in patients with trigeminal sensory neuropathy were determined. Many patients with trigeminal nerve disorders had abnormal electrogustometric detection thresholds suggesting that there is possibly an accessory taste pathway through the trigeminal nerve, although in some individuals the site of lesion may be in the brain stem. Electrogustometry is a convenient method for clinically assessing taste.

Adolescent↗
PubMed1987

Magnetic resonance imaging in the management of resistant focal epilepsy: pathological case report and experience of 12 cases.

Clinical improvement in epilepsy following temporal lobectomy is more often obtained when an abnormality is found on subsequent histological examination. Pre-operative MRI demonstrated an abnormal signal in the temporal lobe of a patient with pathologically proven mesial temporal sclerosis with microvascular anomaly. MRI may therefore be helpful in the selection of patients for temporal lobectomy. MRI findings of 12 patients with resistant focal epilepsy are reviewed. A wide range of T1 and T2 weighting is suggested to maximise selection of patients.

Adult↗
PubMed1987

MRI measurement of syrinx size before and after operation.

When patients with syringomyelia fail to improve after operation, factors such as incomplete cyst decompression or type of operation are often implicated. MRI has been used to confirm adequate syrinx decompression post-operatively and to compare the degree of collapse with the type of operation. Foramen magnum decompression was at least as effective in reducing cyst size as syringo-subarachnoid shunting. MRI may also provide a better classification of syringomyelia.

Foramen Magnum↗